CORONAVIRUS
Heart disease likely helped fuel spike in deaths early in pandemic.
The coronavirus killed tens of thousands in the United States during the pandemic’s first months, but it also left a lesserknown toll: thousands more deaths than would have been expected from heart disease and a handful of other medical conditions, according to an analysis of federal data by the Washington Post.
The analysis suggests that in five hard-hit states and New York City there were 8,300 more deaths from heart problems than would have been typical in March, April and May — an increase of about 27 percent over historical averages.
That spike contributed to Illinois, Massachusetts, Michigan, New Jersey, New York state and New York City having a combined 75,000 “excess deaths” during that period, 17,000 more than the number officially attributed to COVID-19.
While several experts said some of the excess deaths in the analysis almost certainly were unrecognized fatalities from COVID-19, the review suggests that many patients suffering from serious conditions died as a result of delaying or not seeking care as the outbreak progressed and swamped some hospitals.
Normally, heart disease is the leading cause of death in the U.S. But in the early months of the pandemic, some hospital departments were nearly devoid of the heart, cancer, stroke and other patients who populated them before.
More than 50 patients a day “died excess deaths just from heart disease, just in New York City,” said John Puskas, a cardiovascular surgeon at Mount Sinai Hospital in Manhattan. “Frankly, that would explain where all the patients went.”
The analysis of data from March 1 to May 30, using a model previously developed by the Yale University school of public health, shows that heart disease is the major driver of excess deaths, excluding those officially attributed to COVID-19.
As states in the South and West restart their economies and see new cases surge, the excess deaths should serve as a cautionary tale, said Nahid Bhadelia, medical director of Boston University medical school’s Special Pathogens Unit.
“This data underlines the importance of not letting our health systems get to the point where they are so overwhelmed that it spills over and affects people with other medical conditions in our community,” she said.
The number of excess deaths in the U.S. during the pandemic far surpasses the number officially attributed to COVID-19, analyses have shown. The official death counts from the disease are incomplete, according to experts, in part because it spread for weeks before testing was widely available and because the virus kills in a variety of ways that were not recognized early on.
But several experts said the spikes in the causes of death in the new Post analysis suggested a deadly collateral effect of the pandemic. They said the surge in deaths from heart disease and several other conditions matches what they saw in clinics and hospitals and confirms their fears that many patients died after not seeking care.
“This is in line with what we were scared of happening: that we were missing people beforehand and that people were dying of other diseases,” Bhadelia said.
New York City, which reports its COVID-19 statistics separately from the state, quickly became the epicenter of the pandemic in the U.S. and saw more than 4,700 excess deaths from heart disease — more than four times the number of any other jurisdiction the Post examined.
Puskas, the surgeon, said that even at the height of the outbreak, when his hospital was nearly overwhelmed by the pandemic response, it didn’t turn away anyone seeking heart care. Yet the number of cardiovascular patients showing up remained low, he said.
Health care providers everywhere are now reckoning with the consequences.
“All those patients that would typically have been there having cardiovascular care were not there,” Puskas said. “Those who would’ve had emergency lifesaving care did not receive that care, and they then became one of the statistics on your chart.”